JOHN E BROCK (NPI# 1376555227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376555227 |
| Entity Type | Individual |
| Full Name | JOHN E BROCK |
| Credential | D.D.S. |
| Practice Address |
100a Prestige Park Dr Hurricane WV 25526-8417 |
| Mailing Address |
1215 Virginia St E Charleston WV 25301-2908 |
| Practice Telephone | 3047570272 |
| Practice Fax Number | 3047570273 |
| Mailing Telephone | 3043451092 |
| Mailing Fax Number | 3043451095 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3308 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | SPECIALIST, ORAL AND MAXILLOFACIAL SURGERY | 129 | 01 |
| WV | WV DENTAL LIC. | 3308 | 01 |
| WV | 3810012787 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154327393 | John C Brock | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5304 4th Avenue Cir E, Bradenton, FL 34208-5624 | 2005-06-22 |
| 1285021691 | John Brock | Case Manager/Care Coordinator | 700 Brooksedge Blvd, Westerville, OH 43081-2820 | 2015-04-23 |
| 1689773020 | John Brock | Urology | 3601 Tvc, Nashville, TN 37232-0001 | 2006-09-22 |
| 1376573212 | John H Brock | Anesthesiology | 200 Memorial Ave, Westminster, MD 21157-5726 | 2006-07-04 |
| Street Address |
100A PRESTIGE PARK DR |
| City | HURRICANE |
| State | WV |
| Zip Code | 25526-8417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992766737 | Drs Krajekian,brock & Henderson Inc | Dentist | 100a Prestige Park Dr, Hurricane, WV 25526 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081707 | Paige E Walroth | Technician | 51 Overlook Dr, Hurricane, WV 25526 | 2020-10-21 |
| 1770195778 | Marilyn Sue Shank | Technician | 168 Willow Tree Way, Apt 313, Hurricane, WV 25526 | 2020-08-20 |
| 1275150351 | Wv Wellness and Recovery LLC | Clinic/Center | 4 Putnam Village Drive, Hurricane, WV 25526 | 2020-07-06 |
| 1538645718 | Patsy Samples | Technician | 3067 State Rt 34s, Hurricane, WV 25526 | 2018-07-11 |
| 1528550274 | Sarah Marie Jackson | Occupational Therapist | Genesis-putnam Center, 300 Seville Road, Hurricane, WV 25526 | 2018-05-30 |
| 1619466463 | Mh Psychological Services, Pllc | Psychologist | 125 Morris Ct, Hurricane, WV 25526 | 2018-05-08 |
| 1023510740 | William Riddle | Technician | 157 Washington Cirlce, Hurricane, WV 25526 | 2018-03-08 |
| 1942702303 | Natalie Whitman | Technician | 2933 State Route 34 South, Hurricane, WV 25526 | 2018-03-01 |
| 1972002681 | Dianna Roberts | Technician | 550 Dudding Avenue, Hurricane, WV 25526 | 2018-02-08 |
| 1174022875 | Nancy Adams | Technician | 1 Western Hills Drive, Hurricane, WV 25526 | 2018-02-08 |
| Find all providers in zip 25526 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992766737 | Drs Krajekian,brock & Henderson Inc | Dentist | 100a Prestige Park Dr, Hurricane, WV 25526 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255620 | William Black | Dentist | Room 1200 Hsc North, P.o. Box 9475, Morgantown, WV 26506 | 2017-06-18 |
| 1104359959 | Appalachian Oral Surgery Center | Dentist | 3433 University Ave, Suite 1, Morgantown, WV 26505-3052 | 2017-04-09 |
| 1023318201 | James G Bryant Dmd | Dentist | 5000 Hampton Ctr Ste 1, Morgantown, WV 26505-1709 | 2010-10-22 |
| 1053561779 | Drs Krajekian,brock & Henderson Inc | Dentist | 3135 16th Street Rd, Suite 20, Huntington, WV 25701 | 2008-09-30 |
| 1255544748 | Nahla Chaudhary | Dentist | 1007 Sushruta Dr, Martinsburg, WV 25401-8876 | 2007-05-08 |
| 1164646725 | William A. Myers II Dmd Ltd | Dentist | 1191 Pineview Dr Ste D, Morgantown, WV 26505-2778 | 2007-04-12 |
| 1780729251 | Babak D. Noorbakhsh | Dentist | 2801 Dudley Ave Ste C, Parkersburg, WV 26101-2105 | 2007-02-21 |
| 1659442309 | Edward Elias Howard | Dentist | 1321 Virginia St E, Charleston, WV 25301 | 2006-11-13 |
| 1376614024 | Richard Lee Howard | Dentist | 1321 Virginia St East, Charleston, WV 25301 | 2006-11-13 |
| 1356420186 | Peter James Pangilinan | Dentist | 700 W Pike St, Suite 100, Clarksburg, WV 26301-2696 | 2006-11-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.